BACKGROUND: Topical antimicrobial agents have proven efficacy in preventing life-threatening invasive burn wound infection. Under wartime or mass-casualty conditions, however, there may be an inadequate supply of these agents. This study aimed to identify those patients most likely to benefit therefrom. METHODS: Logistical regression analysis of data from the U.S. Army Burn Center was performed. Mortality data for the period immediately preceding the introduction of topical mafenide acetate (MA) (1950-1963) were compared with data for the subsequent period (1964-1968). During the second period, MA was routinely applied but treatment was otherwise similar. The mortality decrement attributed to MA was determined for various ages and burn sizes. RESULTS: For patients of combatant age (20-50 years), MA was associated with a greater than 10% reduction in mortality for those with burns of 40-79% of the total body surface area (TBSA). Only a minimal effect on mortality was noted for those patients with burns smaller than 40% or greater than 79%. CONCLUSIONS: When resources are limited, topical therapy (specifically, MA) is likely to confer the greatest survival benefit for combatants with burns of 40-79% TBSA.
BACKGROUND: Topical antimicrobial agents have proven efficacy in preventing life-threatening invasive burn wound infection. Under wartime or mass-casualty conditions, however, there may be an inadequate supply of these agents. This study aimed to identify those patients most likely to benefit therefrom. METHODS: Logistical regression analysis of data from the U.S. Army Burn Center was performed. Mortality data for the period immediately preceding the introduction of topical mafenide acetate (MA) (1950-1963) were compared with data for the subsequent period (1964-1968). During the second period, MA was routinely applied but treatment was otherwise similar. The mortality decrement attributed to MA was determined for various ages and burn sizes. RESULTS: For patients of combatant age (20-50 years), MA was associated with a greater than 10% reduction in mortality for those with burns of 40-79% of the total body surface area (TBSA). Only a minimal effect on mortality was noted for those patients with burns smaller than 40% or greater than 79%. CONCLUSIONS: When resources are limited, topical therapy (specifically, MA) is likely to confer the greatest survival benefit for combatants with burns of 40-79% TBSA.
Authors: Amir Ibrahim; Shawn Fagan; Tim Keaney; Karim A Sarhane; Derek A Hursey; Philip Chang; Rob Sheridan; Colleen Ryan; Ronald Tompkins; Jeremy Goverman Journal: J Burn Care Res Date: 2014 Jul-Aug Impact factor: 1.845
Authors: Anne M Lachiewicz; Christopher G Hauck; David J Weber; Bruce A Cairns; David van Duin Journal: Clin Infect Dis Date: 2017-11-29 Impact factor: 9.079
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Authors: Fenella D Halstead; Maryam Rauf; Naiem S Moiemen; Amy Bamford; Christopher M Wearn; Adam P Fraise; Peter A Lund; Beryl A Oppenheim; Mark A Webber Journal: PLoS One Date: 2015-09-09 Impact factor: 3.240
Authors: Matthew P Rowan; Leopoldo C Cancio; Eric A Elster; David M Burmeister; Lloyd F Rose; Shanmugasundaram Natesan; Rodney K Chan; Robert J Christy; Kevin K Chung Journal: Crit Care Date: 2015-06-12 Impact factor: 9.097
Authors: J Hauser; O Rossbach; S Langer; P Vogt; G Germann; H U Steinau; K Reimer; M Hopp; B Langer-Brauburger; B Bosse; H H Homann Journal: Unfallchirurg Date: 2007-11 Impact factor: 0.918